Center for Opioid Epidemiology & Policy Research | NYU Langone Health

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Center for Opioid Epidemiology & Policy Center for Opioid Epidemiology & Policy Research

Center for Opioid Epidemiology & Policy Research

Current research in NYU Langone’s Center for Opioid Epidemiology and Policy aims to inform evidence-based policies to prevent opioid misuse, disorder, and overdose in populations nationally and globally. Our work extends into other areas of substance use research related to stimulants and marijuana as well as novel research on the connections between the COVID-19 pandemic and the overdose epidemic.

The following are brief summaries of select projects conducted by our researchers. To stay up to date, please join our mailing list.

Understanding the Intersection of the COVID-19 Pandemic and the Opioid Overdose Epidemic in New York State

This competitive revision expands on the National Institutes of Health-funded parent study by focusing on better understanding how the COVID-19 pandemic and the opioid overdose epidemic intersect within New York state. To do this, a cohort of New York state Medicaid beneficiaries, who were 18 to 64 years of age in 2019, will be identified and followed until March 22, 2022. This will enable researchers to track participants at different stages of the COVID-19 pandemic.

The study’s specific aims are to evaluate whether chronic pain patients receiving Medicaid benefits in New York state in 2019 experienced a higher incidence of COVID-19-diagnosis; to determine if, in the chronic pain patient population, a history of long-term opioid therapy and/or diagnosis of opioid use disorder were associated with a higher incidence of COVID-19 complications; and to investigate whether, in the chronic pain patient population, there was an increase in opioid overdoses after March 1, 2020, when the first COVID-19 case was documented in New York state. This study will determine necessary targets for overdose prevention strategies among people with chronic pain during the COVID-19 pandemic.

Principal Investigator: Magdalena Cerdá, DrPH, MPH

Reducing the Consequences of the COVID-19 Pandemic on the Opioid Overdose Epidemic

This urgent competitive revision will expand on the scope of the parent grant to determine how to mitigate the adverse consequences of the COVID-19 pandemic on the ongoing opioid overdose epidemic, and how to improve the delivery of overdose prevention and treatment services in the context of this crisis.

The study’s specific aims are to determine how policies enacted in response to the COVID-19 pandemic have impacted the use of harm reduction and substance use treatment services, and to examine the relationship between acute changes in SARS-CoV-2 diagnoses and COVID-19 hospitalizations and deaths at the community level on rates of non-fatal and fatal drug overdoses. Datasets from comprehensive sources such as emergency department utilization data, state Medicaid claims, opioid prescriptions, pharmacy and community-based naloxone distribution records, and EMS calls for overdose will be utilized to examine the impact of COVID-19. This work will help build an urgently needed evidence base that can be used to determine how best to manage the adverse effects of COVID-19 on the overdose epidemic.

Principal Investigator: Magdalena Cerdá, DrPH, MPH

Examining the Synergistic Effects of Cannabis and Prescription Opioid Policies on Chronic Pain, Opioid Prescribing, and Opioid Overdose

This study examines the independent and joint impact of prescription opioid (PO) policies and cannabis laws on trends in chronic pain, opioid prescribing practices, opioid misuse, and overdose. We examine these trends in the U.S. population as a whole, using repeated cross-sectional data from the National Survey on Drug Use and Health, as well as in Medicaid patients with chronic pain, using a 45-state Medicaid Analytic eXtract longitudinal cohort. By comparing these trends in states that enacted more restrictive PO policies and less restrictive cannabis laws with states that didn't enact these measures, we aim to identify the types and combinations of policies that will lead to the greatest reduction in opioid-related harm. Read the full abstract for further details.

Principal Investigator: Magdalena Cerdá, DrPH, MPH

Administrative Supplement: Examining the Synergistic Effects of Cannabis and Prescription Opioid Policies on Chronic Pain, Opioid Prescribing, and Opioid Overdose

The administrative supplement builds on the National Institutes of Health-funded parent study by pursuing two aims. The first aim is to develop a taxonomy of opioid policies that classifies states according to the type of provision enacted for each policy of interest, as well as the overall restrictiveness of policies regulating the PO supply and the expansiveness of policies regulating access to treatment for opioid use disorder. The second aim is to use machine learning to determine the types of opioid policy provisions that are the strongest predictors of opioid prescribing, initiation, misuse, and disorder. Identifying these key policy measures will inform states on which combinations of opioid policies are most effective at reducing opioid-related harm. This dataset will be made publicly available for other research teams and policymakers to use in their own work.

Principal Investigator: Magdalena Cerdá, DrPH, MPH

Preventing Overdose Using Information and Data from the Environment (PROVIDENT) Grant

Preventing Overdose Using Information and Data from the Environment, also called PROVIDENT, aims to develop a forecasting tool to identify fatal overdoses and neighborhoods at high risk of future overdose outbreaks. Through an ensemble machine learning approach, the PROVIDENT model seeks to use geospatial data on overdose fatalities in Rhode Island since 2014 to generate an overdose risk index.

The PROVIDENT model also aims to determine whether targeted interventions towards high-risk neighborhoods are more effective at reducing overdose burden than nontargeted interventions. Using PROVIDENT’s model predictions, cities and towns that are assigned to a treatment arm receive targeted interventions for neighborhoods with the highest overdose risk indices, whereas control cities and towns continue to receive nontargeted interventions in accordance with the state’s broader strategic overdose plan.

By comparing fatal and nonfatal opioid overdose rates in locations with targeted interventions with rates in control locations, this project seeks to inform how state and local resources can be allocated for the greatest reduction in overdose mortality. Additionally, the completed PROVIDENT model seeks to enable other states to identify high-risk neighborhoods and target overdose prevention efforts accordingly.

Co-Principal Investigator: Magdalena Cerdá, DrPH, MPH

Trends in Psychosis-Related Hospitalizations Following Cannabis Legalization in Colorado

Funded by a Laboratory for Early Psychosis (LEAP) Center pilot grant from McLean Hospital, this study aims to apply epidemiologic and quasi-experimental methods to electronic health record data to better understand the contribution of changing cannabis policies on incidence and nature of psychosis among youth and adults. In particular, this project will characterize trends in psychosis-related emergency department (ED) visits and hospitalizations across the Denver health system; evaluate whether laws that lowered restrictions on cannabis sales in Colorado were associated with changes in rates of ED visits and hospitalizations for psychosis with and without comorbid cannabis use disorder diagnoses; and assess associations between cannabis dispensary density in Denver and rates of ED visits and hospitalizations for psychosis. Our research team, consisting of faculty across NYU Langone, Harvard Medical School, and Denver Health Medical Center, is a multidisciplinary group of epidemiologists, clinicians, and experts in both cannabis policies and childhood and adolescent psychiatry.

Principal Investigator: Noa Krawczyk, PhD

Bloomberg Opioid Initiative

Funded by Bloomberg Philanthropies, this overdose prevention initiative aims to collaborate with government and community partners to develop, implement, evaluate, and distribute evidence-based solutions to reduce overdose deaths in states and communities that have been hard hit by the opioid crisis. Major partners in the project include Vital Strategies, The Pew Charitable Trusts, CDC Foundation, and Johns Hopkins Bloomberg School of Public Health. Read more about the partnership.

Lead Investigator: Noa Krawczyk, PhD

Development of a Novel Polysubstance Assessment Tool for Vulnerable Subpopulations

This project addresses the real-world complexities of substance use through a focus on the high-risk and complex phenomenon of polysubstance use, a behavior that substantially increases the risk of overdose mortality. Funded by a career development K01 award, we adopt a rigorous mixed-method approach to develop and validate a novel polysubstance use assessment tool for use with vulnerable subpopulations, such as justice-involved people who inject drugs, and identify correlates and motivations of polysubstance use behaviors among this population to inform the development of future targeted interventions. The ability to accurately measure polysubstance use among high-risk populations is a critical step toward developing effective strategies for improving substance-related health outcomes of this population.

Principal Investigator: Amanda M. Bunting, PhD

Influence of Substance Use Treatment and Harm Reduction Engagement on Sexual Health Among People Who Use Illicit Opioids in New York City

There is currently limited understanding of sexually transmitted infection (STI) and sexual health among people who use illicit opioids (PWUIO), with the majority of research to date focused more narrowly on HIV and HCV among those who inject drugs. Also lacking is knowledge of whether medications to treat opioid use disorder and engagement in harm reduction, such as opioid education and naloxone distribution, may affect STI and sexual health among PWUIO through their impacts on substance use, sexual risk, and engagement in care, and if these effects differ among vulnerable subgroups. This proposed pilot research seeks to examine the effects of medications for opioid use disorder and harm reduction on STI and sexual health in a cohort study of PWUIO in New York City.

Principal Investigator: Joy D. Scheidell, PhD, MPH

The Center for Drug Use and HIV Research (CDUHR)

The Center for Drug Use and HIV Research (CDUHR) is an allied and collaborating research center with the Center for Opioid Epidemiology and Policy that focuses on public health issues related to HIV, hepatitis C, and drug use. The center is dedicated to informing programmatic, policy, and grassroots initiatives at the local, state, national, and global levels and to training younger researchers to engage in drug use and HIV-related research. Its administrative core is based at NYU College of Global Public Health and affiliated institutions include Mount Sinai Health System and John Jay College, part of the City University of New York. Several faculty members at the Center for Opioid Epidemiology and Policy also conduct research at CDUHR, including Magdalena Cerdá, DrPh, MPH, and Samuel R. Friedman, PhD.

Past Projects

Prescription Drug Monitoring Programs and Opioid-Related Harm

This project used an empirical approach (i.e., latent transition analysis) to identify the prescription drug monitoring program (PDMP) best practice models that are most effective at reducing prescription opioid overdoses, and that minimize unintended consequences in illegally manufactured opioids. We also examined whether there are sources of heterogeneous policy effects within states, notably focused on medical need for opioids, access to medication-assisted treatment, and socioeconomic characteristics in local (zip code level) areas. Read the full abstract.

Principal Investigator: Magdalena Cerdá, DrPH, MPH

Health and Social Consequences of National Marijuana Legalization

The center worked on an impact evaluation of the health and social consequences of marijuana legalization in Uruguay. In 2013, Uruguay became the first country in the world to legalize recreational marijuana use, and regulate the sale, cultivation, and distribution of marijuana.

In this study, we used a synthetic control group approach to compare changes in marijuana use, other types of substance use, and traffic injuries among adolescents and adults in Uruguay from 2002 to 2018, compared to a synthetic control group of regions in Chile and Argentina in the same time period. Read the full abstract.

Principal Investigator: Magdalena Cerdá, DrPH, MPH

Metropolitan Trajectories of HIV Epidemics and Responses in U.S. Key Populations

Hannah L. Cooper, Samuel R. Friedman, and colleagues investigated how HIV/AIDS-related health outcomes and programs in one key population (KP) can affect HIV/AIDS-related health outcomes and programs in other KPs. They examined these variables in 3 KPs (men who have sex with men, people who inject drugs, and heterosexuals) using a longitudinal cohort of the 96 largest metropolitan statistical areas (MSAs) in the United States. By comparing these variables across time and MSAs, the study aimed to determine the fundamental dynamics of HIV/AIDS epidemics and to inform the development of programs and policies that can prevent HIV/AIDS transmission across KPs. Read the full abstract.

Co-Principal Investigator: Samuel R. Friedman, PhD